Skip to main content

Prototype Prescribing Outlier Dashboard for Great North Medical Group

At OpenPrescribing we are piloting a number of data-driven approaches to identify unusual prescribing and collect feedback on this prescribing to inform development of new tools to support prescribers and organisations to audit and review prescribing. These pilot results are provided for the interest of advanced users, although we don't know how relevant they are in practice. There is substantial variation in prescribing behaviours, across various different areas of medicine. Some variation can be explained by demographic changes, or local policies or guidelines, but much of the remaining variation is less easy to explain.

The DataLab is keen to hear your feedback on the results. You can do this by completing the following survey or emailing us at [email protected]. Please DO NOT INCLUDE IDENTIFIABLE PATIENT information in your feedback. All feedback is helpful, you can send short or detailed feedback.

This report has been developed to automatically identify prescribing patterns at a chemical level which are furthest away from “typical prescribing” and can be classified as an “outlier”. We calculate the number of prescriptions for each chemical in the BNF coding system, the count of all prescriptions within that chemical's BNF subparagraph, for prescriptions dispensed between June 2021 and December 2021. We then calculate the ratio of these counts along with the mean and standard deviation of those ratios across all Practices. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given Practice is from the population mean. We then rank your “z-scores” to find the top 10 results where prescribing is an outlier for prescribing higher than its peers and those where it is an outlier for prescribing lower than its peers.

For each outlier chemical, a kernel density estimation plot of all Practice's chemical:subparagraph ratios is provided, with this Practice's ratio overlaid in red.

It is important to remember that this information was generated automatically and it is therefore likely that some of the behaviour is warranted. This report seeks only to collect information about where this variation may be warranted and where it might not, to inform research on this topic. Our full analytical method code is openly available on GitHub here.

This is a new, experimental feature. We'd love to .

Prescribing where Great North Medical Group is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Fluocinolone acetonide 189 Topical corticosteroids 1,993 0.09 0.01 0.01 9.98
Sulpiride 72 Antipsychotic drugs 833 0.09 0.01 0.01 5.31
Pantoprazole 2,672 Proton pump inhibitors 19,753 0.14 0.02 0.02 5.19
Umeclidinium bromide 1,758 Antimuscarinic bronchodilators 2,290 0.77 0.12 0.13 5.06
Ciprofloxacin/fluocinolone 12 Otitis externa 285 0.04 0.00 0.01 4.92
Phenylephrine hydrochloride 1 Mydriatics and cycloplegics 9 0.11 0.00 0.02 4.88
Duloxetine hydrochloride 2,988 Other antidepressant drugs 6,231 0.48 0.15 0.07 4.38
Alogliptin/metformin 418 Other antidiabetic drugs 5,647 0.07 0.00 0.02 3.94
Trifluoperazine 27 Antipsychotic drugs 833 0.03 0.00 0.01 3.88
Loprazolam mesilate 14 Hypnotics 541 0.03 0.00 0.01 3.70

Prescribing where Great North Medical Group is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gliclazide 332 Sulfonylureas 791 0.42 0.93 0.13 -3.77
Tiotropium bromide 376 Antimuscarinic bronchodilators 2,290 0.16 0.71 0.18 -3.05
Tramadol hydrochloride 32 Opioid analgesics 4,400 0.01 0.27 0.09 -2.87
Acamprosate calcium 0 Alcohol dependence 7 0.00 0.83 0.31 -2.69
    Losartan potassium 389 Angiotensin-II receptor antagonists 4,539 0.09 0.50 0.19 -2.24
    Omeprazole 3,055 Proton pump inhibitors 19,753 0.15 0.50 0.16 -2.12
    Pregabalin 619 Control of epilepsy 5,962 0.10 0.27 0.08 -2.11
    Venlafaxine 487 Other antidepressant drugs 6,231 0.08 0.26 0.09 -2.01
    Diazepam 356 Anxiolytics 714 0.50 0.75 0.13 -1.92
    Prednisolone 7 Copound haemorrhoidal preparations with corticosteroid 106 0.07 0.43 0.24 -1.52